Haemodynamic management of severe sepsis: recommendations of the French Intensive Care Societies (SFAR/SRLF) Consensus Conference, 13 October 2005, Paris, France

We present a consensus report from the SFAR/SLRF (Société Française d'Anesthésie et de Réanimation/Société de Réanimation de Langue Française) Consensus Conference, held on 13 October 2005 in Paris, France. The consensus report made recommendations on five topics relevant to the treatment of circulatory failure in sepsis and its underlying rationale. These topics are as follows: therapeutic goals of haemodynamic support in sepsis; goals of fluid resuscitation (including transfusion); role of inotropes and vasoactive drugs; role of other treatments; and treatment strategy. This report is reproduced from a translation of the original in Annales Francaises of Anesthésie and Réanimation.     

Current structures of cardiac centers

The "Working Group for Congenital Heart Surgery and Pediatric Heart Surgery" of the German Society for Thoracic and Cardiovascular Surgery (GSTCVS) has analysed and recommended structures for congenital heart surgery departments in Germany. The document was worked out according to a similar paper approved earlier by the European Association for Cardio-thoracic Surgery (EACTS). The "Working Group" unifies the majority of cardiac surgeons involved in congenital heart surgery in Germany. Current structures of cardiac centers vary. Therefore the aim of this document is to elucidate additional structural needs for both highly specialized institutions and those for standard care. Specialized centers should allow for treatment of newborns and adult patients with congenital heart disease, include implementation of assist devices and transplantation, possess research facilities and ensure highest standards of education and training. Standard care units do not necessarily need to cater for the above mentioned spectrum. However, the evaluation of quality of care should be given priority in all centers involved in care of patients with congenital heart disease. Data acquisition and transfer must be guaranteed to both the GSTCVS and EACTS in order to ensure national and international comparison of surgical results. This may also give further guidance for improved patient care.     

逆转肿瘤耐药性的策略及相关小分子药物的研究进展

多药耐药(multidrug resistance, MDR)是肿瘤化疗失败最常见而又最难解决的问题。研究 MDR 机制,开发具有克服 MDR 作用的新型化疗药物是抗肿瘤药物研究的一个热点领域。肿瘤细胞耐药是一个复杂的、动态的体系,可以发生在细胞膜或细胞质水平,也可发生在细胞解毒系统、DNA 修复系统以及药物作用靶点的改变上。该文在总结逆转肿瘤耐药性策略的基础上,对 MDR 逆转剂、作用于细胞解毒系统以及作用于 Bcl-2 家族、DNMT和 p53 等新靶点的小分子药物的研究进展进行综述。     

认知行为干预对抑郁症患者婚姻质量和家庭功能的影响

目的探讨认知行为干预对抑郁症患者婚姻质量和家庭功能的影响．方法以住院抑郁症患者为研究对象,共入组146例,按照入组顺序分为研究组和对照组．研究组采用认知行为干预,对照组采用抑郁症常规护理．采用汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）、家庭功能评定量表（FAD）、婚姻质量问卷（ENRICH）评估抑郁症患者的症状改变和家庭功能变化．结果研究组ENRICH总分、婚姻满意度、解决冲突方式、子女和婚姻、业余活动、与亲友的关系、FAD总分、问题解决、情感反应干预前后差异有统计学意义（P〈0．05）;第6周,2组间ENRICH总分、婚姻满意度、解决冲突方式、子女和婚姻、业余活动、与亲友的关系、FAD总分、问题解决、情感反应差异有统计学意义（P〈0．05）;对第0、6周的组内比较,2组HAMD、HAMA评分差异均有统计学意义（P〈0．05）;HAMA分与解决冲突方式因子分成负相关（r=-0．48,P〈O．05）,FAD总分与HAMD分成正相关（r=0．43,P〈0．05）,ENRICH总分与HAMD分成负相关（r=-0．46,P〈0．05）．结论认知行为干预可以改善抑郁症患者家庭功能,提高婚姻质量．     

维药恰玛古的性状和显微鉴别

目的对维药恰玛古的生药学特征进行研究,为进一步研究和利用恰玛古奠定基础。方法对恰玛古原植物进行性状鉴别和显微鉴别。结果根的次生构造较发达,茎中维管束为外韧型,叶中有分泌腔存在。粉末中有较多方晶散在,气孔为不等式。结论本研究结果为该药的鉴别、质量标准制定及开发利用提供依据。     

靶向于流感病毒神经氨酸酶新位点的抑制剂研究进展

流感是由流感病毒引起的一种严重影响人类生命健康的传染性疾病。神经氨酸酶是流感病毒表面的一种重要糖蛋白,在病毒的复制周期中起着关键作用,是抗流感病毒合理药物设计的理想靶点。自2006年以来,结构生物学研究发现了神经氨酸酶新的配体结合位点,为新型神经氨酸酶抑制剂的设计提供了依据。本文综述了靶向于神经氨酸酶新结合位点的抑制剂的研究。     

郑州市社区老年冠心病患者衰弱现状及影响因素分析

目的 了解郑州市社区老年冠心病患者衰弱现状及主要影响因素。方法 采用一般资料调查表、Tilburg衰弱量表等工具,对郑州市2个社区821例老年冠心病患者衰弱现状进行调查,采用多因素logistic回归分析筛查影响因素。结果 老年冠心病患者衰弱发生率为24.0%;logistic回归分析显示,年龄(60～69)岁(OR = 0.348, 95%CI: 0.159～0.764)、不服药(OR = 0.247, 95%CI:0.134～0.456)、认知正常(OR = 0.511,95%CI:0.283～0.923)、不抑郁(OR = 0.177,95%CI:0.096～0.327)、高握力(OR = 0.686,95%CI:0.634～0.742)、高BMI(OR = 0.830,95%CI:0.765～0.900)是社区老年冠心病患者衰弱的保护因素(P＜0.05),缺乏运动(OR = 3.392,95%CI: 1.948～5.904)、空腹血糖(OR = 2.293,95%CI:1.745～3.015)、心率(OR = 1.035,95%CI: 1.012～1.060)、甘油三酯(OR = 1.418, 95%CI:1.096～1.834)、低密度脂蛋白胆固醇(OR = 3.447,95%CI:2.268～5.238)是社区老年冠心病患者衰弱的危险因素(P＜0.05)。结论 郑州市社区老年冠心病患者衰弱发生率高,并且受多种可控因素的影响,应予以重视。